Provider Demographics
NPI:1679875348
Name:TERAN, CARMEN (MA CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:CARMEN
Middle Name:
Last Name:TERAN
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 JABEZ ST
Mailing Address - Street 2:2ND FL.
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-3100
Mailing Address - Country:US
Mailing Address - Phone:917-434-1819
Mailing Address - Fax:
Practice Address - Street 1:52 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5200
Practice Address - Country:US
Practice Address - Phone:201-820-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist